Approach to a Newly Diagnosed Adult with Type 2 Diabetes in the Indian Context: Recommendations by Association of Clinical Endocrinologists Consensus Group

Abstract

Grading system uses A, B, C, or E to show the evidence level that supports each recommendation.• A -Clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered.• B -Supportive evidence from well-conducted cohort studies.

A Practical Approach to the Initiation, Titration and Intensification of Insulin Therapy in Adults with Diabetes in the Indian Context: Recommendations by Association of Clinical Endocrinologists Consensus Group

“…Most episodes of hypoglycemia can be self-treated by ingestion of glucose or CHO-containing juices, soft drinks, candy, other snacks, or a meal. A good amount of CHOs (15-20 g) can be given again in 15-20 minutes if necessary [55]. Since the glycemic response to oral glucose is transient, it is often advised to consume a larger snack or meal soon after the plasma glucose level is corrected to the normal range with oral glucose.…”

“…Precipitating causes need to be investigated at the earliest opportunity and appropriately managed. Education about hypoglycemia prevention and treatment should be part and parcel of every visit of the person by the doctor [55].…”

“…People with diabetes who consume alcohol should be advised to avoid or limit alcohol intake [55]. Alcohol intake is associated with risks such as weight gain, hyperglycemia (for those who consume excessive quantities of CHO-rich drinks), and hypoglycemia (especially for those taking insulin or insulin secretagogue therapy) [86].…”

Do We Need Another Guideline on Managing Type 2 Diabetes in India?

“…A systematic guideline based on evidence can help to aid cost-effective, safe, and evidence-based treatment for people with T2D. Therefore, a clinical guideline on the management of newly diagnosed adults with T2D by the Association of Clinical Endocrinologists of India (ACE) is a welcome step [3].…”

“…In the present issue of "Clinical Diabetology", the Association of Clinical Endocrinologists working group from India comes with new guidance on managing T2D among Asian Indians [3]. What is new in the ACE guidelines?…”